”A theatre for the generation of meaning”.

Notes on Meltzers theory of dreaming and the mind.

I have called this paper: ”A theatre for the generation of meaning”. Notes on Meltzers theory of dreaming and the mind. I will take a piece of clinical material as my vantage point, and then discuss my views on Meltzers theory of dreaming. To give you a broad picture of my ideas here, an overview, let me start with a résumé in 10 points:

Dreaming is the principal way human beings think about feelings.

By trying to figure out what has happened to us, by reflecting on our emotions, we try to create meaning and coherence in our lives – when we are dreaming.

This meaning is highly personal and no one can do it on behalf on us. The fate of the dreaming processes plays a great part in shaping our personality.

And yet, we need help from good inner objects in order to create the dream, and to make the symbols that incarnate the meaning.

The symbol-making activity, what Bion named alpha-function, rests on an object-relation based on trust in good inner objects, what Klein called the good breast, who does the hard and mysterious work in transforming muddled emotional situations into poetic symbols that we can use as tools in order to think about our feelings and create meaning.

Meltzer has shown that this is a relation based on the self’s trust and dependency on its good objects, and that the self has to give the objects their freedom.

By creating the symbols that make it possible to think about our feelings, the mind creates itself, bit by bit. The mind doesn’t unfold like a flower, according to a fixed program or schedule. It is formed by learning from experience, in unpredictable ways.

The dreaming activity goes on day and night, in the night we call it a dream, in the day; unconscious phantasies. In children’s play, in the grown up’s free association, and in the transference, we try to read this unconscious phantasy, this dreaming.

The dream is a picture of the transference, an ongoing commentary on what goes on between patient and therapist, and also…

… a view to the patient’s inner world. A view of his objects and inner object relations, a view of his defences and what he does with his feelings.

I will start with a short clinical fragment including a dream, and then elaborate on these points as they evolve from the clinical material. The dreamer is a young woman that sought treatment after a big crisis in her life with depressive symptoms and some anxiety attacks. She said in the initial interview that she thought her problems dated from an early age, and that she wanted to look into that as well as the recent events that led up to this crisis. She had grown up with a brother and a sister, the brother two years older, the sister one year her junior. She told me she was closer to her father than mother, but that he became more distant as she entered puberty. She is very tense in the sessions, palpably afraid of saying the wrong things. She says she feels powerless and that the therapist seems austere and distant to her. In one of the first sessions she relates a dream:

I stand in front of an operating table, like I am a surgeon or a nurse. A child is lying on the table, famished, emaciated, with a protruding stomach and almost without skin. It has big, brown eyes. It is very vulnerable, perhaps dying. By my side there is a woman and a man. They seem very skilful, adept, while I feel small, insecure, and I don’t know what to do. I then find myself looking at a curious apparatus. It indicates that I am to blame, not the other ones. I feel a lot of guilt and shame.

She told me that she had reflected on the dream, and that many of its elements seemed familiar to her. She continued: “Maybe the emaciated, starving child, almost without skin, is a portrait of me and how I have felt these last few months during this crisis. The other part of me in the dream, the surgeon or nurse character who is so very insecure and under great pressure, also reminds me of something familiar; feelings of anxiety, of not measuring up to things, of not being good enough or handling the situation – both at these sessions with you and elsewhere in my life. But what is it with this guilt machine, I don’t get that.” I will skip more of her thoughts and associations now, and jump straight to one way of interpreting this dream, continuing along the lines that this intelligent patient has started on:

1. First of all I will focus on the feelings, the emotions. I find them intense and dramatic; those that are portrayed in the dream, and also those feelings that the dream may evoke in us, the ones who listen to it. If we focus on the starving child, we might say that the dream portrays feelings of being in a crisis, in desperate need of food and protection, on a metaphorical level most likely in desperate need of emotional food; love, care, warmth – nurture of a mental kind as well as physical. And this at a point where it is almost too late – the child is dying. Concerning the surgeon or nurse character, the protagonist, the self in the dream, there are feelings of great insecurity, of not being good enough, of not handling the situation, and perhaps a fear of being criticised or even punished for not doing the right thing. And then there is the strange apparatus that measures faults, and her feelings of shame and guilt at the end of the dream. These are feelings that seem more unfamiliar or strange to the dreamer. Why guilt? I’ll return to that.

First a note about Meltzer and feelings. He says that Freud regarded feelings almost like they were some kind of sand in the machinery, or some sort of appendix, en epiphenomenon. In contrast, Meltzer says, Bion saw feelings as the essence of mind. Let me quote him on this: “Mental health, and the development of the mind, derives from intimate relationships in which the primordial events are emotional experiences. Bion’s work places emotion at the very heart of meaning. What he says in effect (and this is almost diametrically opposed to Freud’s attitude towards emotion) is that the emotional experience of the intimate relationship has to be thought about and understood if the mind is to grow and develop. In a sense the emotion is the meaning of the experience and everything that is evolved in the mind through alpha-function such as dreaming, verbalizing dreams, painting pictures, writing music, performing scientific functions – all of these are representations of the meaning.” (Meltzer, 1984, p. 44)

In my view feelings help us in orientating ourselves to our existential situation, our Dasein, our being there – as Heidegger put it. Our emotions tell us something about what is important for us; matters of life and death and love. But we don’t always listen to this speech, this emotional truth about our lives is too frightening, too overwhelming, too embarrassing.

Now, we could say that this woman already at the beginning of her therapy has begun to do this mind-work, this therapeutic work. She has begun to think about her feelings and her existential situation – learning by experience, to use Bion’s expression. She has created symbols that manage to portray feelings, we might also use the word contain feelings. This, I think, is something that we hope the analytic work will produce or facilitate; that the patient becomes capable of making symbols that give (artistic) form to his experiences, and thereby strengthening his possibilities to create meaning and coherence in his life. Meltzer reminded us that Freud talked about Bindung (in German), and the binding effect of thought. Bion and Meltzer showed that if the mind doesn’t succeed in dreaming, in creating symbols that allows us to think about our feelings, then these situations and experiences doesn’t simply vanish without a clue. No, these impressions continue to make themselves felt in our minds, but now as symptoms, as anxiety, as hallucinations, as psychosomatic ailments (Bion called them somapsychotic to indicate their psychotic level of transformation), as interpersonal trouble – problems in relationships, as basic assumption group phenomena like racism or scapegoating, as projective identifications where others are made to suffer the raw feelings that the projector can’t handle himself. Bion said that we can either do mental work, think about, these difficult feelings, and then the mind grows and expands, or we could try not to think about it, evade it – and this will lead to pathology of different kinds. Let me quote him:

The choice that matters to the psycho-analyst is one that lies between procedures designed to evade frustration and those designed to modify it. That is the critical decision. (Bion, 1961, p. 29, italics in original)

This is a distinction Bion never tires of reminding us about, for instance the very last words of his long and strange novel A memoir of the future (Bion, 1991, p. 576):

Wisdom or oblivion – take your choice. From that warfare there is no release.

This is also a very Freudian way of thinking. I quote again from Learning from experience:

An emotional experience that is felt to be painful may initiate an attempt either to evade or to modify the pain according to the capacity of the personality to tolerate frustration. Evasion or modification in accordance with the view expressed by Freud in his paper on Two Principles of Mental Functioning are intended to remove the pain. (Bion, 1961, s. 48)

But what if one can’t tolerate the frustration, can’t modify the pain, doesn’t manage to think about the emotions? Bion says that we need to find a thinking breast to help us with this mind-work. We need to share, to project our unmodified, raw proto-feelings into this maternal container to have them worked upon there, so that they can return in a form that the mind can handle. In effect, what he says, is that projective identification is the beginning of thinking. That is, if the object that receives the proto-feelings, or beta-elements as he named them, is willing and capable of doing the work of containing, reverie and symbol formation that could modify these raw feelings into something the mind can handle, into alpha-elements. Meltzer points out that this way of seeing it puts the object relation at the centre of the mind, that the most vital part of the mind consists of a relation between needy parts of the self that are dependent on good, thinking, caring inner objects – what Klein would call the good breast. Klein (1957) describes this relation, in Envy and gratitude:

Throughout my work I have attributed fundamental importance to the infant's first object relation – the relation to the mother's breast and to the mother – and have drawn the conclusion that if this primal object, which is introjected, takes root in the ego with relative security, the basis for a satisfactory development is laid. (…)

…the breast is instinctively felt to be the source of nourishment and therefore, in a deeper sense, of life itself. (p.178)

The good breast is taken in and becomes part of the ego, and the infant who was first inside the mother now has the mother inside himself. (ibid, p.179)

The mind is inherently relational, one might put it. And dreams show us this, I think.

If we return now to my woman patient, I think that her depressive crisis and anxiety attacks were a result of not managing to contain and work on these feelings in the dreaming process. And perhaps beginning in therapy instigated a hope that made it possible to dream this dream, of which the essence might be said to be: “I am in a very bad shape now – like this emaciated, skinless child, and I could really need some help. Are there any good objects around to help me with these very difficult feelings?”

But then, we may ask; what is her model of how to get help? How is her model of being dependent on other people, including inner objects? The dream, I think, gives us an idea about that. Let me elaborate on this point here; the object relation and the inner world.

2. We could say then, that this dream gives us a pretty clear view of a part of her inner world. A world of relations to inner objects, some good, some bad, some ambiguous. The woman and the man that stand beside her, we could see as potentially good objects. She told me that the man reminded her of a colleague who is very good at what he does, but also somewhat aloof and unapproachable. It is like this pair is highly professional and adept, but of no use to her, as they seem to require that she manages by herself, without their help. This could be a reminiscence of how her parents related to her sometimes. Perhaps they treated her more like an adult than as a child? Perhaps they were too busy with her siblings and saw her as more independent and self-reliant than she really was? Or is it rather that she doesn’t dare to trust the woman and the man, like she didn’t trusted her parents the way she could have done? That she can’t bring herself to ask them to help her? These viewpoints don’t exclude one another; it could be a combination of both. Could it be that the dream shows us her model of how to get help from others, based on her early history; which is actually a model of managing on one’s own rather than getting any help from others. It is even worse; the people, the objects, that could have helped her, are in fact there to put a judgment on her, to make her feel insecure, under pressure, not good enough, to criticise her. This is not a good breast, in Klein’s sense of the word, it’s a breast that threatens to become a bad breast, a persecuting presence.

Now, I will dwell on this detail in the dream, this object relation, and look at it from many angles and levels, because I find it illustrates an essential element in order to understand how Meltzer sees the mind and how we manage to create symbols to contain our feelings. I also think that this dream can tell us a lot about this particular woman’s problems and give us some clues about ways of dealing with them.

As I understand Meltzer, he says that in the centre of the mind, in the mind’s kernel, so to speak, we find a relationship based on trust and dependence. This is the relation between what Bion calls the contained and the container, ♂ and ♀, or between the self and its good objects. The self needs to put its trust in good objects in order to get help; help in containing and transforming impressions and experiences so that we can think about our feelings and our place in the world. I see the woman and the man standing beside the dreamer as such potentially good objects, as potential containers for her raw feelings. I see them as objects that possibly could help her in bearing and tolerating these almost unbearable feelings. Feelings of being needy, hungry, small, unprotected, cold and shivering, and to experience that these feelings can be felt, they are acceptable, not damnable. Not so in the dream though, where it seems like the balance is tipped from a situation where these difficult feelings can be felt and given a symbolic form – this we can call a depressive situation or position, tipped towards a situation where these feelings are not acceptable, where they need to be split off and projected onto the objects. When this happens the objects turn into persecutors. The potential good objects, the pair in the dream, turn into bad objects that are unwilling to help, that rather criticise her, arrogantly. I think the dream shows the precarious balance in the mind that Bion described as a perpetual oscillation between the depressive position and the paranoid-schizoid position; ps↔d. My impression is that many dreams oscillate between the positions like this.

And this of course, also gives us a picture of some of the turbulence and coming proceedings in the transference, where the therapist will turn into somebody that instead of being a kind listener, someone to confide in, to trust, will turn into someone that you have to placate, to perform in front of, and fear hard criticism from – hence her grave tenseness in the sessions.

I think, though, that even if such a dream gives you as therapist a very clear picture of the transference, you can’t avoid enacting the role you unconsciously are casted in; what Joseph Sandler called role responsiveness or role actualisation.But with the dream in mind, I think it is easier to discover what kind of object you have become in the transference, and then given a possibility to talk about it with your patient: “It seems like I have turned into that guy in the dream in the operating theatre who didn’t help you at all, but rather criticised you from an aloof position?” Or: “Could it be that you feel that you have to perform in front of me, that I demand that from you, rather than me being someone that you could rely on, someone that listens to you, care for you?” I don’t know if Meltzer would agree with this way of working, this is me speaking, so you have to excuse me on this point. As you probably have guessed, I am also influenced by interpersonal authors like Harry Stack Sullivan, Edgar Levenson and Donnel Stern. But I think Meltzer would agree that there is an intimate connection between dreams and the transference, and that the dreams can be seen as a running commentary on how the transference-situation evolves. I see no contradiction between working with dreams and giving top priority to the transference, like I have heard someone say. I would like to say something very obvious here, perhaps it would seem banal to you. The transference is invisible, an immaterial fact. We can stand in the middle of it, surrounded on all sides, and still doesn’t discover it. That is why I find Paula Heimann’s question: “Who is talking to whom?” so immensely helpful. This question – I try to keep it like an invisible plate on my wall, a constant reminder – helps us to discover what you have become in the patient’s experience, what role you are casted in. It helps us to focus more on the way the patient is talking to us, than the contents of his speech. There is a kind of Norwegian psychotherapeutic dogma or saying that goes like this: Form before content. Perhaps you have this in Russia too? Well, anyhow, it took me some time to discover that she often spoke to me like I was someone she had to capture the attention from, make herself interesting in front of, rather than someone that listened to her with care and interest. This I think we see in the dream, but it can be difficult to recognise when the dream materializes in the consulting room, in the transference and in the counter-transference. Edgar Levenson, who works in the Sullivanian, interpersonal tradition, also helps me to orientate myself to these immaterial facts with his pertinent question: “What is going on around here?” He also says; “You can’t not interact!” We are also in some degree drawn into enacting a part in the patient’s inner world. In this therapy I oftentimes became like the aloof, critical man standing beside her in the dream. It was important to put that into words, to describe what kind of person I had become in the room with her. Merton Gill (1982), another American that I find interesting, made the expression: “The resistance to the awareness of the transference”. Something in the patient doesn’t want to hear about the transference, wants things to stay the way they are – what Betty Joseph named psychic equilibrium. This resistance I think is often very strong also in the therapist. It takes courage to put into words what’s going on between the participants in the analytic encounter. This James Strachey (1934) wrote about in the very last page of his famous paper on mutative interpretations.

I think that this detail in the dream, this picture of her relation to the woman and the man, also illustrates one of Bion’s most interesting observations: He says that all feelings are feelings in relation to an object. He says in Learning from experience (Bion, 1962): ”An emotional experience cannot be conceived of in isolation from a relationship.” (s. 42) This, I think, is something that both Freud and Klein said before him. Freud (1912) says in “The dynamics of transference”:

“How does it come about that transference is so admirably suited to be a means of resistance? It might be thought that the answer can be given without difficulty. For it is evident that it becomes particularly hard to admit to any proscribed wishful impulse if it has to be revealed in front of the very person to whom the impulse relates. (p. 104)

This is the situation in treatment, in the transference; the patient has to admit feelings that he carries to the very same person that he feels these things towards, and this person is the very same that is supposed to help him contain them. What a mess! And in our inner world the situation is pretty much the same: “Look you, inner good object, this is how I really feel about you – isn’t it horrible to feel something like that! How can you stand me?” This of course, brings us to Klein’s depressive anxiety; the fear that the object will fall apart if we reveal our inner feelings, if we be honest, if we are sincere. If this anxiety grows too big, the splitting and projective processes are set in motion, and all hell breaks loose. I think we can locate this process in the dream, or at least the beginnings of such a course. Here I would like to mention that I see the guilt machine, the apparatus for measuring faults, as a sign of hope. How? We could think of this strange apparatus, as a kind of object inside her, a wise one, that tells her that she is in part responsible for the proceedings; she has a part to play in turning the woman and the man into someone that could help her, rather than criticise and ridicule her. She could be more of an agent than a victim, but that would demand a lot of trust and courage from her. And perhaps people that are in therapy sometimes really show a lot of courage in trusting someone they don’t know at all, a complete stranger.

This touches upon the point about freedom, what Meltzer says about giving the objects their freedom. It takes a lot of hope and trust to do that, I think. He puts it like this in an article titled A note on introjective processes: ”(W)hen an object can be given the freedom to come and go as it will, the moment of experience of relationship with that object can be introjected” (Meltzer, 1978b, s. 468). I understand what he says here as something along these lines: In order to get in touch with your good inner objects, you have to loosen your grip on them. You have to let go of the illusion of omnipotence, that you own your objects, that they are in your possession. In other words; to acknowledge your separateness from the good object, and accordingly, your dependency. Klein stresses that this is a process of mourning, to let go of the object.